2019 -- H 5580

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LC001708

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTH CARE FACILITIES

     

     Introduced By: Representatives Lima, Serpa, Shekarchi, Williams, and Ucci

     Date Introduced: February 27, 2019

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 23-17-44 of the General Laws in Chapter 23-17 entitled "Licensing

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of Health-Care Facilities" is hereby amended to read as follows:

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     23-17-44. Moratorium on new initial nursing-facility licensed beds and on increases

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to the licensed capacity of existing nursing-facility licenses.

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     (a) The licensing agency shall issue no new initial licenses for nursing facilities prior to

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July 1, 2019 2022; provided, however, that any person holding a nursing facility license may

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undertake activities to construct and operate a replacement nursing facility with the same or lower

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bed capacity as is presently licensed, provided that the replacement facility may only be licensed

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upon the otherwise unconditional cessation of operation of the previously licensed nursing

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facility;

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     (b) Prior to July 1, 2019 2022, and with the exception of the culture initiative pursuant to

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subsection (d), the licensing agency shall not increase the licensed bed capacity of any existing

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licensed nursing facility, including any nursing facility approved for change in ownership

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pursuant to §§ 23-17-14.3 and 23-17-14.4, to greater than the level of the facility's licensed bed

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capacity as of August 21, 1996, plus the greater of ten (10) beds or ten percent (10%) of the

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licensed bed capacity. Any person holding a previously issued and valid certificate of need as of

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the date of passage of this section, or who shall subsequently be granted a certificate of need

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pursuant to subsection (a), shall be permitted to effect a prior certificate from the licensing agency

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consistent with any other statutory and regulatory provisions that may further apply.

 

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Notwithstanding any other provision of the law to the contrary, including any moratorium on

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increasing bed capacity in nursing facilities that may otherwise apply, the licensing agency shall

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be permitted to increase the licensed bed capacity of an existing nursing facility by no more than

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the number of beds previously licensed to one or more other licensed nursing facilities provided

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that:

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     (1) All nursing facilities involved in any such transaction must be located within the same

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municipality;

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     (2) The owner of a licensed nursing care facility seeking to increase its licensed bed

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capacity must receive approval, following review by the health services council from the

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licensing agency for change in owner of the nursing facility or facilities;

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     (3) The nursing facility's licensed bed capacity may only be increased upon the otherwise

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unconditional cessation of operation of the previously licensed other nursing facility or facilities

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and the return of the license of the nursing facility or nursing facilities to the licensing agency;

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and

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     (4) The licensed nursing care facility seeking to increase its licensed bed complement

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must comply with any requirements of the health care certificate of need act, chapter 15 of title

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23.

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     (c) Notwithstanding any other provision of the law to the contrary, including any

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moratorium on increasing bed capacity in nursing facilities that may otherwise apply, a nursing

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facility may take out of service any or all beds of its licensed capacity without impediment to its

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right to place back into service those beds at a future date under the same terms and conditions as

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applied at the time of taking them out of service.

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     (d) Culture-change initiative. Notwithstanding any other provision of the law to the

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contrary, including any moratorium on increasing bed capacity in nursing facilities that may

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otherwise apply, the licensing agency may increase the licensed bed capacity of any existing

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licensed nursing facility, including any nursing facility approved for change in ownership

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pursuant to §§ 23-17-14.3 and 23-17-14.4, for the purposes of nursing facility culture change, in

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accordance with the following criteria and procedures:

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     (i) Culture-change definitions and criteria shall be established through regulation to

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restrict beds added under this initiative only to beds that are designed to provide enhanced quality

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of life to nursing facility residents through the adoption of principles and building designs

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established by the "Eden Alternative", "Green House", or "Small House" programs or other like

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means;

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     (ii) Only beds taken out of service due to facility closure after January 1, 2010, shall be

 

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available for facility expansion under this culture-change initiative subsection. The total number

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of beds that may be licensed to increase capacity under this culture-change initiative shall be

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limited to ninety percent (90%) of the first fifty (50) beds that are taken out of service, to seventy

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percent (70%) of the next fifty (50) beds that are taken out of service, and to fifty percent (50%)

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of any additional beds taken out of service;

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     (iii) Only nursing facilities licensed in the state are eligible to expand under the culture-

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change initiative;

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     (iv) The department shall promulgate regulations to govern an open and competitive

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process to determine the licensure of expansion beds under this culture-change initiative, and

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shall consider the impact on the regional distribution of, and access to, nursing facility beds in the

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state; and

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     (v) Any facility seeking to expand its licensed bed capacity under this initiative, that will

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result in an expenditure that meets or exceeds the criteria for determination of need review under

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chapter 15 of title 23, shall be required to receive approval under chapter 15 of title 23.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTH CARE FACILITIES

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     This act would mandate that no new initial licenses for nursing facilities would be issued

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prior to July 1, 2022. Also, prior to July 1, 2022, the licensing agency would not be allowed to

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increase the licensed bed capacity of any existing licensed nursing facility including any nursing

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facility approved for change in ownership.

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     This act would take effect upon passage.

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